Lactase insufficiency: symptoms, diagnosis and diet

What are the symptoms of lactase insufficiency? Is it possible to keep breastfeeding if lactose failure was detected? How to diagnose lactose failure? Answers to these questions you will find in the article.

Content

Lactase insufficiency

Although there is no such term in official medicine -
«Milk intolerance», - It is often used in everyday life when they want
Describe some digestive problems. Typically called
Unpleasant sensations arising from milk intake: abdominal pain,
Meteorism, liquid chair or just discomfort. These problems are often
Meet the infants, and are often associated with intolerance
Lactose. Lactose is milk sugar, which makes up about 99% of all
carbohydrates of any milk, including female. Lactose gives milk
Sweet taste and consists of glucose supplied energy, and galactose,
necessary for the formation of the central nervous system and retina
eyes.

In the gastrointestinal tract enzyme lactase
(generated by enterocytes - cells of the mucous membrane of thin
intestine) breaks off lactose on glucose and galactose and then these
Monosahara is absorbed. However, the breast child gets so much
lactoses that even in healthy children up to 3 months, she is not split off
fully. In the unreserved (untouched) form, it enters
the colon and there becomes a nutrient medium for useful
lactic acid bacteria (bifidobacteria, lactobacilli,
lactose positive intestinal sticks). These bacteria break off lactose
On gases, water and short-chain fatty acids (from here, and sour smell
stool in infants). Acid data are important for regulation
Peristaltics (abbreviations) of intestines, suction of salts and water. except
that acidic medium prevents the reproduction of rotten bacteria.
Therefore, if you immediately deprive the child with lactose (for example, feed it
only with lactose-free mixtures), then useful bacteria will not receive power,
The acidity of intestinal contents and the intestines will be populated
Pause microbes.

However, if there are non-depleted lactose in
the intestine is too much (the activity of the splitting lactase is reduced), and
lactic acid bacteria is not enough, then undigested lactose
provokes the receipt of water from the body to the cavity of the intestine, in
A result of a child develops a liquid chair (diarrhea). Such a state
called lactase insufficiency. Lactasine failure is
primary and secondary.

Symptoms of lactase deficiency

Sometimes parents do not even know about their lactase deficiency. They say they just don't like milk.

Primary
lactase insufficiency is called a condition at which reduced
The activity of the enzyme lactase, but the enterocytes producing it is not
Damaged. Primary congenital lactase failure - congenital
Violation of the lactase production process, quite rare.
In addition, there is a lactase deficiency of an adult type -
Situation when lactase activity falls at the end of the period
breastfeeding (usually such a decrease occurs by 3-5 years).
In both embodiments, the biochemical mechanism of violations is the same as
Indicates its hereditary nature. Baby can inherit
Initially low enzyme activity from their parents.
Indeed, congenital violations most often found in families,
Where the intolerance of milk is in adults, although sometimes parents even
do not recognize about their lactase insufficiency. they say that
just don't like milk or that in their families is not accepted to drink him.

Also primary lactase failure
meets in premature babies, docking, but immature kids.
The fact is that the high activity of lactase is needed only by the time
birth, and fetal enzyme activity begins to grow about 34
pregnancy week reaching the maximum level by 37-40 week.
So the premature babe can have a low activity of lactase at
Birth. This condition is called transient lactase
insufficiency. As can be seen from the very name, it over time
passes, and the activity of the enzyme is normalized.

Anxiety of a child when feeding with milk,
Increased gas formation and liquefied stools are as typical
Symptoms of primary lactase deficiency. The baby usually has
good appetite, greedily starts to suck, but a few minutes later
crying, throws her chest, presses the legs to the stomach. Chair frequent, liquid,
Yellow, with sour smell, frothy (reminds yeast dough). If
assemble a chair in a glass container and give to stand up, it becomes clear
Vidno bundle on fractions: liquid and more dense. Need to have B
mind that when using disposable diapers liquid part
absorbs in them, and then the stool violations can not be noticed.

Usually symptoms of primary lactase deficiency
grow with increasing volume of milk consumed. First, in the first
the week of life of the newborn, there are no signs at all
violations, then enhanced gas formation appears, even later -
abdominal pain, and only then - liquid chair.

If a child has a frequent watery foamy chair with a sour smell, he can suspect lactose intolerance.

Any inflammation of the intestines - infectious or not -
leads to damage to enterocytes. Therefore, much more often
face secondary lactase insufficiency in which
stool a lot of mucus, greenery and unsemored lumps
Food.

Special mention deserves secondary lactase
Insufficiency arising against the background of allergic inflammation in
intestine when the main disease is food allergies, and
lactase failure turns out to be only a complication.

With artificial feeding may be observed
intolerance when a child starts to get too early
Alien protein - most often protein of cow's milk or soy,
contained in mixtures for artificial feeding. In the intestines, ON
Begins to interact with the cells of the mucous membrane. Immune
Cells recognize «stranger», and the reaction of the immune system is developing -
Allergic inflammation. As a result, generating lactase
Enterocytes are damaged. In addition, such children are broken
The permeability of the intestinal mucosa, many substances cease
Diarrhea (rapid liquid stool) is absorbed and developed. Allergic
Inflammation in the intestine, as a rule, precedes changes to the skin,
Therefore, at the beginning, allergies may not have any external signs.

With natural feeding can also develop
Allergic intestinal inflammation if a nursing mother uses
Allergy products. The most dangerous in this respect are considered
Citrus, Fruits and Berries of Red, Nuts, Honey, Smoked.
Less dangerous cottage cheese and chicken, but if you use them often and in large
quantities, they can also cause an allergic reaction at the kid.

Diagnosis of lactase insufficiency

So, if a child has a frequent watery foamy chair
with sour smell, it can be suspected lactose intolerance.
Before a visit to the doctor, try to remember if you immediately with the beginning
The child's feeding appeared diarrhea or after the introduction of some new
Products. Nursing mom will have to remember what changes occurred
in her own diet.

The simplest and most affordable study for
Definition of lactose intolerance - determination of the amount of carbohydrates
in Kale. This analysis does not mean anything about the cause of intolerance and even
does not indicate which carbohydrate is not transferred. But he is going fast,
cheap and makes it possible to understand whether there is a disruption of digestion and
Suction carbohydrates. Since children get only breast milk,
Use mainly lactose, this test is enough to speak
About lactase deficiency. In other cases, it is advisable to conduct
More specific tests.

«Gold standard» Diagnostics lactase
Insufficiency is to determine the activity of the enzyme in a small
Fragment of the mucous membrane of the small intestine, but this is a survey
It is carried out only in cases where you need to distinguish the failure of this
Enzyme from other diseases. The survey necessarily includes
Research of feces on dysbacteriosis, and with suspected allergies -
Blood test for specific antibodies to potential allergens.

Diet with lactase insufficiency

At the time of the survey, and in confirmation of the diagnosis - and in the future, the content of lactose in the diet should be reduced.
Natural feeding preserve! If the child got his breast
milk, then you do not need to deny it this beautiful product. But at the same time
prescribe lactase enzyme (drug «Baby lactase»). A drug
produced in capsules - it is convenient for older children and adults, t.To.
The capsule protects the enzyme itself from digesting in the stomach. And for breasts
Children of the capsule open and bring the enzyme directly into the milk.
It is only necessary to see part of the volume of one feeding, in the applied milk
add an enzyme and then read the kid by the remaining milk by it
wishes. Lactase is prescribed to each feeding, the dosage of the enzyme and
The proportion of milk you need to write, selected by a doctor
individually: the more carbohydrates do not absorb, the greater the share
Milk must be previously processed by the enzyme.

If has
place allergic to products used by a nursing mother, enough
adjust its diet. But temporarily prescribed lactase.

With mixed or artificial feed
Adapted milk mixture is replaced by lowolate or
Bedless. About the selection of therapeutic mixture is better to consult with a doctor,
Since excessive reduction in lactose in the diet is also undesirable - it
can lead to constipation. With primary lactase deficiency
Mixtures are prescribed, differing from standard carbohydrate composition
(lactose is replaced with maltose, glucose polymers and other sugars), and
The protein remains cow.

In food allergies, it makes sense low-colors
diet, but only until the allergic is eliminated
inflammation, then the activity of the enzyme is rapidly restored. If
Insufficiency developed due to allergies to cow proteins
Milk, prescribe specialized mixtures for the treatment of allergies,
containing either other proteins (for example, soy) or protein of the same
cow milk, but specially processed (split to short
Fragments and amino acids).

It is important to know that soy protein is alien,
and goat milk protein, and even split protein can contain
Elements that can cause allergies in a sick child.

For children older than a year, milk use is no longer
is so significant, but still for them milk and dairy products
Important. Acid foods contain approximately two times less
lactose than solid milk. Many patients with lactase
Adult insufficiency calmly transfer milk
products, but they still need to limit the use of rich
lactose products - condensed milk, ice cream and t.NS. Limit
The use of cheeses, butter is usually no need.

Lactase
Insufficiency with timely diagnostics is easily treated, but important
remember that treatment is selected individually. Its durability
depends on the type of disease. With transient lactase insufficiency
premature it takes 1-3 months, with congenital - as long as
Milk is used. If the lactase adult failure has been revealed
type, lactase preparation is recommended to be used always when in the diet
Lactose rich foods.